Fresh Blood in Stool: When to See a Specialist

Diarrhea with fresh blood in the stool?

Hello Doctor, today I had two bowel movements.
The first one was around noon, and after using the toilet, I noticed bright red blood in the toilet bowl (not attached to the stool).
There was also a significant amount of blood when I wiped my anus with toilet paper.
In the evening, I experienced diarrhea, and the toilet was almost entirely filled with bright red blood.
The amount of bleeding was substantial, and the blood on the toilet paper was more than in the afternoon.
However, there is no pain in the anus, and this is not my first experience with blood in my stool.
I had a colonoscopy at 17 and another at 23 (which showed internal and external hemorrhoids).
Each time, the amount of bleeding scares me.
I would like to know if I should see a proctologist for an examination soon.
Why does this occasional heavy rectal bleeding occur? Thank you for your response, Doctor.

Mǐjiāng, 20~29 year old female. Ask Date: 2020/07/26

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Increasing dietary fiber intake can also be beneficial.
Warm sitz baths may help alleviate symptoms, and over-the-counter hemorrhoidal suppositories can be used.
It is best to avoid taking stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician.
Frequent colonoscopy examinations should not be necessary; instead, pay attention to lifestyle habits and bowel movement patterns.

Reply Date: 2020/07/26

More Info

When it comes to the presence of fresh blood in stool, it is essential to take this symptom seriously, especially given your history of hemorrhoids and previous colonoscopies. Fresh blood in the stool can indicate various conditions, some of which may require immediate medical attention.

Firstly, the fact that you have experienced significant amounts of fresh blood, particularly during bowel movements, is concerning. While hemorrhoids can cause bleeding, the volume of blood you describe—especially if it is more than what you have experienced in the past—could suggest other underlying issues that may need to be investigated. Conditions such as diverticulosis, inflammatory bowel disease (IBD), colorectal polyps, or even colorectal cancer can present with similar symptoms.
Given your age and medical history, it is advisable to consult a specialist, specifically a gastroenterologist or a colorectal surgeon. They can perform a thorough evaluation, which may include a physical examination and possibly another colonoscopy to assess the current state of your gastrointestinal tract. This is particularly important since you have a history of hemorrhoids, which can complicate the clinical picture.

In terms of why you might experience intermittent episodes of significant bleeding, there are several factors to consider. Hemorrhoids can flare up due to straining during bowel movements, constipation, or prolonged sitting. However, if the bleeding is excessive or accompanied by other symptoms such as abdominal pain, changes in bowel habits, or weight loss, it could indicate a more serious condition that requires prompt attention.

Additionally, if you notice any changes in the characteristics of your stool, such as consistency or color, or if you experience symptoms like dizziness or fainting, these could be signs of significant blood loss and warrant immediate medical evaluation.

In summary, while hemorrhoids can cause fresh blood in the stool, the volume and frequency of your symptoms suggest that it would be prudent to seek a specialist's opinion. Regular monitoring and follow-up with your healthcare provider are crucial in managing your symptoms and ensuring that any potential issues are addressed promptly. Do not hesitate to reach out to a gastroenterologist to discuss your symptoms and determine the best course of action.

Similar Q&A

Understanding Blood in Stool: When to See a Specialist

If you initially had normal bowel movements but then suddenly experienced blood clots and bloody stools, resulting in a toilet full of blood, this is concerning. You should see a gastroenterologist for evaluation and diagnosis.

Dr. Li Qinglong reply Surgery
It is recommended that you visit a hospital to see a colorectal surgeon for diagnosis.

Understanding Blood in Stool: When to See a Doctor and What Tests to Expect

If you often notice blood at the bottom of the toilet after having a bowel movement, with no blood elsewhere, and the blood appears to be mixed with stool but is not very noticeable, and the blood is not bright red while the stool is brown, which type of specialist should you see...

Dr. Xiao Yongxun reply Internal Medicine
Dear Mr. Ryook: 1. Generally speaking, if the blood in the stool appears bright red, it may indicate lower gastrointestinal bleeding; if the color is dark black and shiny like tar, it should be considered as upper gastrointestinal bleeding. 2. Stool that is brown in color can...

Blood in Stool: Should You See a Doctor or Wait and Observe?

I previously had irritable bowel syndrome, and recently, due to stress, I've experienced a recurrence along with constipation (occasionally, my stool has been very hard, and I've noticed a small amount of blood on the toilet paper). Yesterday, I suddenly had a strong ur...

Dr. Ke Fangxu reply Surgery
In this situation, it is recommended to maintain a light diet and a good daily routine. Spicy, irritating, and greasy foods should be avoided. If symptoms persist without improvement, you may consult a physician for medication or undergo a colonoscopy.

Understanding Blood in Stool: When to Seek Medical Attention

I am not someone who has a bowel movement every day, but about two weeks ago, I started experiencing bloody stools. At first, it was occasional, so I didn't pay much attention to it. However, starting this week, I have had bloody stools every day, and there are also blood st...

Dr. Xu Kaixi reply Surgery
Blood in the stool or changes in bowel habits, including alterations in stool shape or consistency, are abnormal gastrointestinal function changes. It is recommended to visit a gastroenterology department for further evaluation.